Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $760.00 / $1,478.51 / $2,068.10	Facility		$760.00	$1,478.51	$2,068.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.60 / $585.20 / $737.20	Professional		$501.60	$585.20	$737.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.00 / $1,380.67 / $1,725.84	Professional		$912.00	$1,380.67	$1,725.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $646.00 / $1,026.00 / $1,375.60	Professional		$646.00	$1,026.00	$1,375.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $722.00 / $988.99 / $1,945.60	Facility		$722.00	$988.99	$1,945.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $483.74 / $2,968.77	Professional		$456.00	$483.74	$2,968.77
Midlands Facility/Professional Facility Modifier Low / Median / High Price $912.00 / $1,330.00 / $1,945.60	Facility		$912.00	$1,330.00	$1,945.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $912.00 / $1,330.00 / $1,961.22	Professional		$912.00	$1,330.00	$1,961.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $760.00 / $760.00 / $1,356.60	Professional		$760.00	$760.00	$1,356.60
United Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $456.00 / $1,656.80	Professional		$456.00	$456.00	$1,656.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $760.00 / $760.00 / $760.00	Professional		$760.00	$760.00	$760.00